“People say kidney stones and childbirth are not as bad. It’s excruciatingly painful, and (the joint) will become egg-frying hot. It’s amazing to watch,” said Dr. Alan Friedman, a Texas rheumatologist and a member of the board of the American College of Rheumatology’s research and education foundation.

A lot of people, mostly men, know this all too well: A study published last year said that gout now affects 4 percent of Americans, or 8.3 million people.

Gout is becoming more common because people are living longer and often have high blood pressure and are obese, both of which contribute to the disease, said Dr. Zhanna Mikulik, a rheumatologist at Ohio State University’s Wexner Medical Center.

Gout attacks stem from abnormally high levels of uric acid in the bloodstream. Flare-ups occur when the uric acid leaves the blood and accumulates in the joints as crystals, prompting white blood cells to flood the area.

“The crystals ... look like they don’t belong there to the white blood cells, and they try to eat them for breakfast to get rid of them,” Friedman said. “The white blood cells release nasty chemicals while they’re doing that, and that’s what causes the heat and redness and pain.”

Everyone has uric acid in their bloodstream; it is a natural byproduct of the breakdown of purines — compounds that are found in many foods and beverages and are abundant in some, such as red meat, shellfish and beer.

But in someone with gout, the level of uric acid is abnormally high, leading to recurring attacks of joint inflammation. The first stop for gout is usually the big toe (because the body temperature is lower there, and uric acid can more easily leave the blood), but it affects other joints as well.

The condition is much more common in men (even more so in black men), but it occurs in post-menopausal women as well. Its roots are in genetics, but the mutations that cause it are different from family to family, Friedman said.

Treating a gout attack in the short term usually involves either an anti-inflammatory, a drug called colchicine or steroids.

When the pain and inflammation subside, there’s no telling when or where they will return. Lucky people might go a year or more between attacks. Others suffer attack after attack.

Doctors say most gout patients should go on long-term medication that lowers uric acid rather than to try to react to attacks as they occur.For four decades, there was only one option (allopurinol); now, there is another pill. Anyone who watches TV is probably familiar with Uloric, which has been heavily advertised since its Food and Drug Administration approval three years ago.

There’s also a new IV medication called Krystexxa for those with severe gout that doesn’t respond to the other medications.

Many gout sufferers turn to natural methods, including modifying their diets, drinking more water, losing weight, exercising and taking supplements. Eliminating medications that aggravate gout — including aspirin — also is recommended, if it’s possible.

Doctors say that although those methods offer benefits, they often aren’t enough to nix the gout. The only supplement that has shown some benefit scientifically is pure cherry concentrate, said Dr. Marc Antonchak, a rheumatologist with the Columbus Arthritis Center.

Mikulik said that many patients who come to her out of frustration have a poor understanding of the disease.

“They need to be on a uric-lowering agent if they have flare after flare after flare,” she said. Repeated severe flares can eventually cause permanent joint damage.

Dr. Heather Lake, a rheumatologist at Grant Medical Center, said it’s not uncommon for patients to have a gout flare after they start taking gout medication. Obviously, that’s frustrating, but it’s just a product of the body’s getting used to the change, and it will pass, she said.

Uric acid should be tested during a pain-free time (not right after a gout attack) to determine whether it’s high. The only slam-dunk test for gout is to remove fluid from the joint to look for the crystals. And tests should be run to look for problems with the kidneys, which can contribute to high uric acid.

Dick Glenn, who lives in Dublin, signed up for the clinical trial that tested Krystexxa (the IV medication) when he realized that his gout was impeding his ability to get to work and do things that he enjoys.

Since he ended his involvement in that study in 2009, he has been doing well without taking medication, he said.